I(we) hereby authorize Acton Academy Columbus, hereinafter called "School," to initiate debit entries to my (our) account indicated below at the depository financial institution named below, hereinafter called "Depository," and to debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.

This authorization is to remain in full force and effect until the School has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the School and Depository a reasonable opportunity to act on it.

I understand that the payments will be drafted on the same day of each month (or the following business day if the scheduled date falls on a weekend or holiday) for the amount owed as indicated on my (our) tuition invoice.

I (we) understand that insufficient funds, declined payments, or account closures resulting in failed transactions may incur additional fees and that continued non-payment may result in suspension of services.

If you're uncertain of your account or routing number, please attach a voided check or bank letter confirming account information.